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ID PMID Title PublicationDate abstract
8531373 [Recurrent annular erythema--cutaneous manifestation of Sjögren syndrome with anti SS-A ( 1995 Oct Eight cases of Sjögren syndrome (SjS) with anti-SS-A and anti-SS-B antibodies are reported. They developed erythema annulare centrifugum-like annular erythema which mainly appeared on the face. Laboratory tests showed similar serologic changes. RA factor, speckled type antinuclear antibody, anti SS-A & SS-B antibodies (DID & ELISA) were observed but complements and anti-double stranded DNA antibodies were not detected. In spite of mild sicca symptoms, sialogram, lip biopsy, Shirmer test and Rose Bengal staining showed typical changes of SjS. It is considered that the recurrent annular erythema is a specific skin manifestation of SjS with anti SS-A/SS-B antibodies.
8531361 [EBER-1 expression in salivary glands of Sjögren's syndrome]. 1995 Oct EB virus-encoded small nuclear RNAs (EBERs) which present in large numbers during persistent infection, are known to stably bind to SSB/La antigen, leading to speculation that EBV may be involved in the pathogenesis of primary Sjögren's syndrome (1 degree SjS). Although studied by many investigators serologically, immunohistochemically and molecular biologically, this remains controversial. In situ hybridization study for EBER-1 showed positive hybridization in ductal epithelial cells in nine of eighteen salivary glands (SGs). Hybridization was more intense in ducts surrounded by infiltrating mononuclear cells (MNCs). Positive hybridization was also seen in infiltrating MNCs in eight 1 degree SjS SGs. These results indicate that EBV plays some pathogenic roles in some cases of 1 degree SjS through induction of SSB/La antibody and impairment of lymphocytes.
7795622 Ischemic optic neuropathy and high-level anticardiolipin antibodies in primary Sjögren's 1995 Apr A 39-year-old woman with recurrent severe anterior ischemic optic neuropathy in the setting of Sjögren's syndrome was found to have high-titer IgM anticardiolipin antibodies (aCL) that were enhanced by the phospholipid-binding glycoprotein beta 2GP1. The recognition of IgM aCL-associated vasculopathy as a possible etiologic factor in the optic neuropathy in Sjögren's syndrome may be relevant in deciding appropriate therapy.
7597901 [Diagnostic value of labial salivary biopsy in Sjogren's syndrome: report of 182 cases]. 1995 Feb Various sets of criteria have been suggested in order to establish a diagnosis of Sjögren's syndrome (SS) in as much as evaluation of the salivary component is highly controversial. Our study was aimed at investigating both sensitivity and specificity of labial salivary gland biopsy (LSGB), as well as at comparing this method with other diagnostic procedures commonly employed in SS. LSGB was performed in 182 patients (174 female and 8 male, mean age 51.2) with xerostomia, dry eyes, parotid swelling and/or serological abnormalities such as positive rheumatoid factors, antinuclear antibodies, leukopenia and hypergammaglobulinemia. Diagnosis of SS was made according to the criteria recently proposed by Vitali et al. (1993). Severity of histologic changes was graded according to the Chisholm and Mason scoring system. Bioptic samples were considered abnormal when at least one focus of mononuclear cells/4mm2 was observed. The following parameters were also assessed in each patient: questionnaire of symptoms, Saxon test, sialography, salivary dynamic scintiscan, Schirmer-I-test, rose Bengal score, ANA, anti-SSA/SSB antibodies and rheumatoid factors. According to the above diagnostic criteria, 108 out of 182 patients had SS, 90 primary and 18 secondary. For 74 there were not enough data for a definite diagnosis of SS. In 9 cases (4 with and 5 without SS) LSGB was excluded because no glandular tissue was found in the specimens. Among the remaining 173, Grades 3 or 4 were found in 74 patients (71.2%) with SS and only in 1 case (1.4%) without SS. LSGB showed a very high specificity (98.6%) and a rather good sensitivity (72.5%). However, biopsy was crucial for diagnosis in only 11 cases (14.6%).(ABSTRACT TRUNCATED AT 250 WORDS)
7718958 Pulmonary hypertension and antiphospholipid antibody in a patient with Sjögren's syndrome 1994 Dec A 57-year-old female patient with Sjögren's syndrome was complicated with pulmonary hypertension (PH) and antiphospholipid antibody (aPL). She had a history of fetal losses, deep vein thrombosis and chronic thyroiditis. On admission, severe pulmonary hypertension, thrombocytopenia, lupus anticoagulant and a decreased level of protein C were found. Pulmonary artery perfusion scintigram revealed multiple defects. She died suddenly despite an intensive therapy. Intimal proliferation with angiomatoid lesions in small pulmonary arteries was observed by autopsy. Since a close relationship between PH and aPL in connective tissue disease is found, it is important to carefully analyze the antiphospholipid antibodies in patients with PH.
8036402 [For practical salivary flowmetry. A weighing technic]. 1994 No one method of salivary flowmetry has been found to be practical, reliable and fully significant. Consequently, the diagnosis of salivary gland failure remains uncertain and imprecise even though the diagnostic question is often raised. A simplified and effective weight measurement could be more widely used. Saliva is sampled easily with small compresses inserted into the sublingual groove and left in potion for 5 minutes without deglutition or mastication for a saliva collection and close as possible to the baseline level; then for 1 minute after mastication to collect stimulated secretion. The compresses are then weighted. The reliability of this method must be confirmed with a multicentric study.
8240666 Monoclonal antibody detection of laminin in minor salivary glands of patients with Sjögre 1993 Oct The potential roles of the basement membrane proteins, laminin and fibronectin, and the cytoskeletal protein, tubulin, were assessed in the pathogenesis of Sjögren's Syndrome (SS) by comparing their expressions in SS with normal labial salivary gland (LSG) tissue. Laminin, fibronectin and tubulin expression were determined using well characterized monoclonal antibodies in the peroxidase anti-peroxidase technique on formalin-fixed LSG's from patients with SS and normal controls. Characteristic periductal staining for laminin occurred in the LSG's of 14/18 SS patients scored by one observer and 16/18 scored by the second observer. Staining of LSG's for laminin occurred in 2/35 control specimens consisting of 15 normal LSG's and 20 inflammatory lesions with attached normal LSG. The staining which occurred in the two controls was diffuse and 'non-specific' in one case, and indistinguishable from the characteristic periductal staining found in SS in the other case. Among the 20 controls containing inflammatory lesions, four showed diffuse staining for laminin within the actual lesion, but the adjacent LSG's did not stain. No statistically significant difference between SS and normal tissues stained by anti-fibronectin and anti-tubulin was observed. The study concluded that there was an increase in laminin or a laminin-like substance on salivary ductal epithelia of SS patients. This suggests a potential role for laminin in the pathologic mechanism and may indicate that increased laminin expression is a marker for SS.
8316909 [A case of Sjögren's syndrome at the age of 91 with a lymphoepithelial lesion]. 1993 Apr A 91 year old woman with Sjögren's syndrome who developed a lymphoepithelial lesion and showed an active state of the disease is described. Since June, 1990, the patient had been complaining of dry eyes and mouth and a left submandibular tumor (1.0 x 1.5 cm in diameter). A biopsy of the tumor revealed lymphoepithelial lesions in the salivary gland. Mild anemia (Hb 9.6 g/dl) and an elevated erythrocyte sedimentation rate (80 mm/hr) were noted. The gamma-globulin level was 2.7 g/dl, IgG 2789 mg/dl, IgA 469 mg/dl, RAHA x80, antinuclear antibody x20, anti-SS-A x256, thyroid test x400 and microsome test x102400. The Schirmer's test showed decreased tear secretion (Lt. 3mm, Rt. 9mm) and keratoconjunctivitis sicca were noticed by an ophthalmologist. Salivary scintigraphy revealed decreased uptake and slow excretion of the isotope (grade II). A biopsy of a minor salivary gland showed periductal lymphocytic infiltration and acinar cell destruction. Immunohistochemical analyses revealed the cross-reactive idiotype of a monoclonal rheumatoid factor which is associated with a patient with Sjögren's syndrome, in the infiltrating lymphocytes and plasma cells of the minor salivary glands, but not in the lymphoepithelial lesions of the left submandibular gland. This was a rare case concerning a 91-year old patient with Sjögren's syndrome who developed a lymphoepithelial lesion and showed high activity in the serum and gives us valuable information on the relationship between aging and autoimmunity.
8484099 Multicentric Castleman's disease in a patient with primary Sjögren's syndrome. 1993 A 38-year-old woman suffering from primary Sjögren's syndrome for 2 years developed angiofollicular hyperplasia (multicentric Castleman's disease). In Sjögren's syndrome (SS) a number of findings indicate the presence of a B-cell hyperactivity that may evolve to a lymphoproliferative disorder. This report adds another pathological event to the complex spectrum of lymphoproliferative diseases in SS.
8440054 Urticated annular erythema: a new manifestation of Sjögren's syndrome. 1993 Jan A patient with a unique urticated annular erythema associated with Sjögren's syndrome and some features of systemic lupus erythematosus (SLE) is reported. There has been one previous report of a similar eruption occurring in a patient with Sjögren's syndrome.
8391170 [Jaccoud's type arthritis in a patient with unclassified connective tissue disease complic 1993 Apr The association between Jaccoud's type arthritis and systemic lupus erythematosus (SLE) is well recognized. Myositis, various arthropathy, and an assortment of miscellaneous connective tissue disorders have been described in association with malignancies. To date however Jaccoud's type arthritis has not been reported in unclassified connective tissue disease (UCTD) complicated with alveolar cell carcinoma (ACC). We describe a UCTD patient who presented LE cells, fluorescent antinuclear antibody (FANA), developing nonerosive, deforming arthritis and ACC. The case is a 59-year-old female who was admitted to our department in November, 1991 for exacerbated exertional dyspnea. She presented with UCTD of six years duration, characterized during follow-up by no history of rheumatic fever or Sjögren's syndrome, nor SLE. Five years later from onset of UCTD, her fingers developed a marked ulnar deviation, as well as pronounced swan-neck deformities. However, radiology did not show the marginal erosions of rheumatoid arthritis. A chest radiograph revealed a reticulogranular shadow in allover lung field, and a lung scintigram showed perfusion dominant mismatched defect in bilateral lower lung field. A transbronchial lung biopsy of B8a was diagnostic for ACC.
9275631 [Preliminary diagnostic criteria for primary Sjogren's syndrome in China]. 1996 Feb Primary Sjogren's syndrome (pSS) is a common autoimmune connective tissue disease in China yet without a universally accepted diagnostic criteria. In this study a new criteria was proposed and compared with other six sets of criteria. Fifty-five items in 112 pSS and 185 controls were evaluated. Results show the criteria we proposed contained one major and nine minor items. For the purpose of identifying patients in clinical studies, a major with at least three of the nine minor items or at least five of the minor items should be presented. The major item is anti-SSA/SSB(+) and the minors are, (1) dry eyes or dry mouth (> 3 months, persistently), (2) swollen salivary glands (recurrently or persistently), (3) rampant dental caries, (4) Schirmer test (< 5 mm in 5 min.) or corneal staining(+), (5) unstimulated salivary flow (< 0.03 ml/min) or abornal parotid sialography, (6) minor salivary gland biopsy (> or = 1 focus), (7) renal tubular acidosis, (8) hypergammaglobuminemia (gamma globulin > or = 30%) or hypergammaglobuminemic purpura, (9) RF > 1 : 20 or ANA > 1 : 20. Other connective tissure diseases, pre-existing lymphoma, AIDS, sarcoidosis, graft vs host disease must be excluded. The criteria we proposed had a high specificity of 98.2% and sensitivity of 94.1%.
8782140 Unmet service needs of children with rheumatic diseases and their parents in a metropolita 1996 Jun OBJECTIVE: To identify perceived unmet service needs of children with rheumatic diseases and their parents in a metropolitan area in order to better plan and coordinate services. METHODS: A pretested questionnaire was sent to 327 families identified from the caseloads and mailing lists of local agencies and a parent support group. RESULTS: After 2 mailings and a telephone followup, 65.0% had responded, 34.4% with complete questionnaire data. The predominant diagnosis was juvenile rheumatoid arthritis (JRA), 58% of parents completing the questionnaire (children 45%) identified a need for additional services, most frequently education (newsletters/books) and teen support groups. Parents of male children selected more services. Problems in school, most commonly related to gym, mobility, and attendance, were reported by 45.5% of the school age children (by parents 49.1%). CONCLUSION: Services for children with rheumatic diseases need to address problems in school, the educational needs of parents and children, and the support needs of the teen group. These results will be used by the agencies involved to plan a more coordinated approach to care for these children.
1498258 Induction of swelling, synovial hyperplasia and cartilage proteoglycan loss upon intra-art 1992 May Transforming growth factor beta (TGF-beta) is a multifunctional homodimeric polypeptide with potent actions upon many target cells, including those of mesenchymal and haemopoietic lineage. The recent reports of high levels of the cytokine in rheumatoid synovium and synovial fluid, prompted this study into the effect of intra-articular injection of TGF beta-2 into rabbit knee-joints. Four daily injections of 1 microgram caused swelling, probably as a consequence of prostaglandin E2 production, synovial fibroblastic hyperplasia and a striking loss of femoral condyle proteoglycan. Using the polymerase chain reaction, no evidence could be obtained for the induction of interleukin-1 alpha gene expression in either synovial tissue or synovial fluid cells. These findings suggest that the TGF-beta present in the rheumatoid joint may contribute directly to the pathogenesis of rheumatoid arthritis.
8629573 A rational approach to the diagnosis of arthritis. 1996 Mar The evaluation of patients with joint pain begins during the medical history and the physical examination, when the differential diagnosis can often be narrowed to a few likely possibilities. Many patients with joint pain have mild, self-limited symptoms that are best managed conservatively. Exceptions are patients with acute monoarthritis with effusion, in whom septic arthritis must often be excluded by diagnostic joint aspiration. Patients with evidence of active joint inflammation also require prompt evaluation. Laboratory tests for rheumatologic problems lack the sensitivity and specificity to allow their use as screening tools. Laboratory tests are most valuable when used selectively in patients with a clinically significant likelihood of disease. A single test used to rule in or rule out the most likely joint disease is more helpful than a panel of tests used for every patient with joint pain. Testing should aid in determining prognosis or planning treatment.
7939137 Effect of acetylsalicylic acid and dexamethasone on antibody production in adjuvant arthri 1994 The production of antibodies to IgG and type II collagen occurs in a similar fashion in human rheumatoid arthritis and adjuvant arthritis. In this study, the effect of dexamethasone (DXT) and acetylsalicylic acid (ASA) on antibody synthesis was analysed. Daily treatment with DXT (0.3 mg/kg per day p.o.) or with ASA (200 mg/kg per day p.o.) from day 14 to day 56 after arthritis induction inhibited both the synthesis of antibodies to IgG and type II collagen and also the humoral immune response to the mycobacteria that induced the disease. The immunosuppressive response was similar for both drugs: DXT, which is known to suppress the immune response, and ASA, a classical anti-inflammatory agent.
8545382 [Treatment of rheumatoid psoriasis with bromocriptine]. 1995 Nov 18 Non-steroid anti-inflammatory drugs and/or gold salts were unsuccessful alone in providing symptom relief in three men with rheumatoid psoriasis. All three were treated with bromocriptine (5 mg/d in 2 doses) after verification of normal baseline and protirelin-stimulation prolactin levels. There was a beneficial effect in nocturnal pain relief, morning stiffness, the Lee and Ritchie scores and biological markers of inflammation. Two of the patients were able to return to regular work occupation after 15 and 45 days. In the third patient, bromocriptine was discontinued due to nausea and dizziness but was reintroduced successfully in fractionated doses after recurrence of the symptomatology. Treatment was continued without secondary adverse effects for 3 to 9 months providing continued symptom relief. Bromocriptine can be an effective adjuvant for the management of rheumatoid psoriasis.
7986222 Measurement of health status in children with juvenile rheumatoid arthritis. 1994 Dec OBJECTIVE: To develop and validate a self- or parent-administered instrument for measuring functional status in children with juvenile rheumatoid arthritis (JRA). METHODS: We adapted the Stanford Health Assessment Questionnaire (HAQ) for use in children ages 1-19 years, by adding several new questions, such that for each functional area, there was at least 1 question relevant to children of all ages. The face validity of the instrument was evaluated by a group of 20 health professionals and parents of 22 healthy children. The questionnaire was then administered to parents of 72 JRA patients (mean age 9.1 years, onset type systemic in 16, polyarticular in 21, pauciarticular in 35). RESULTS: The instrument showed excellent internal reliability (Cronbach's alpha = 0.94), with a mean inter-item correlation of 0.6. The convergent validity was demonstrated by strong correlations of the Disability Index (average of scores on all functional areas) with Steinbrocker functional class (Kendall's tau b = 0.77, P < 0.0001), number of involved joints (Kendall's tau b = 0.67, P < 0.0001), and morning stiffness (Kendall's tau b = 0.54, P < 0.0001). Spearman's correlation coefficient between Disability Index scores from questionnaires administered to parents and those from questionnaires administered to older children (> 8 years) was 0.84 (n = 29; P < 0.001), showing that parents can accurately report for their children. The test-retest reliability, studied at a 2-week interval, revealed virtually identical Disability Index scores measured on the 2 occasions (0.96 versus 0.96; P > 0.9 by paired t-test; Spearman's correlation coefficient = 0.8, P < 0.002). CONCLUSION: The Childhood HAQ, which takes less than 10 minutes to complete, is a valid, reliable, and sensitive instrument for measuring functional status in children with JRA.
7584176 Intra-articular osteoid osteoma of the humerus with synovitis simulating chronic monoarthr 1994 We present a case of intra-articular osteoid osteoma of the humerus simulating chronic monoarthritis of the elbow in an 18-year-old male right-handed recreational tennis player. CT revealed a well-defined nidus in the coronoid fossa. Microscopic examination of the synovium showed a lymphofollicular synovitis that resembled the synovitis in rheumatoid arthritis.
8142176 [The painful wrist joint: alloplastic joint replacement]. 1993 The analysis of the etiology of the painful wrist demonstrates quite clearly an increasing number of "carpal collapse" as a sequence of trauma (perilunar dislocation), of congenital disorders and rheumatoid arthritis. The deterioration of the wrist joint may start locally but may end up with generalised deforming osteo-arthritis. In addition to traditional salvage operations (partial/total fusion, carpectomy) the total wrist prosthesis by Meuli (ball and socket joint) has its definite place in the treatment of the painful destruction and instability of the wrist.